| NPI | 1609973684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: UT 3106175-1205) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: UT 3106175-1205) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2022-06-13 |